Coccidioidomycosis of the Testis and Epididymis


This report describes an unusual presentation of a man with a testicular mass who presented in diabetic ketoacidosis to the emergency department. Initial diagnosis was a suspected testicular malignancy based on history, physical exam, and available laboratory and radiological imaging. Due to the possibility of a testicular malignancy, the patient was taken for immediate orchiectomy. Histology revealed coccidioido-mycosis of the left testicle and epididymis. Treatment with the appropriate antifungals was initiated. Despite aggressive multi-disciplinary therapy the patient continued to deteriorate and eventually expired as a result of the massive systemic infection. Literature review revealed the presentation of disseminated genitourinary coccidioidomycosis is rare and seldom reported.

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D. Klett and Y. Hong, "Coccidioidomycosis of the Testis and Epididymis," Open Journal of Urology, Vol. 3 No. 2, 2013, pp. 87-89. doi: 10.4236/oju.2013.32017.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] N. M. Ampel, “Chapter 200: Coccidioidomycosis,” In: D. L. Longo, A. S. Fauci, D. L. Kasper, S. L. Hauser, J. L. Jameson and J. Loscalzo, Eds., Harrison’s Principles of Internal Medicine, 18th Edition, McGraw-Hill, New York, 2012.
[2] D. A. Stevens, “Coccidioidomycosis,” New England Journal of Medicine, Vol. 332, No. 16, 1995, pp. 1077-1082. doi:10.1056/NEJM199504203321607
[3] G. J. Wise, G. S. Talluri and V. K. Marella, “Fungal Infections of the Genitourinary System: Manifestations, Diagnosis, and Treatment,” Urologic Clinics of North America, Vol. 26, No. 4, 1999, pp. 701-718. doi:10.1016/S0094-0143(05)70212-3
[4] H. M. Weyrauch, F. W. Norman and J. B. Bassett, “Coccidioidomycosis of the Genital Tract,” California Medicine, Vol. 72, No. 6, 1950, pp. 465-468.
[5] J. G. Rohn, J. C. Davila and T. E. Gibson, “Urogenital Aspects of Coccidioidomycosis: Review of the Literature and Report of Two Cases,” Journal of Urology, Vol. 65, No. 4, 1951, pp. 660-667.
[6] G. Amromin and C. M. Blumenfeld, “Coccidioidomycosis of the Epididymis,” California Medicine, Vol. 78, No. 2, 1953, pp. 136-138.
[7] J. M. Pace, “Coccidioidomycosis of the Epididymis,” Southern Medical Journal, Vol. 48, No. 3, 1955, pp. 259-260. doi:10.1097/00007611-195503000-00007
[8] H. Bodner, A. H. Howard and J. H. Kaplan, “Coccidioidomycosis of the Spermatic Cord; Roentgen Therapy— Report of a Case,” The Journal of the International College of Surgeons, Vol. 32, 1959, pp. 530-532.
[9] B. G. Stewart, “Epididymitis and Prostatitis due to Coccidioidomycosis: A Case Report with 5-Year Follow-Up,” Journal of Urology, Vol. 91, 1964, pp. 280-281.
[10] S. Weitzner, “Coccidioidomycosis of Prostate and Epididymis—Case Report and Review of Literature,” Southwest Medical, Vol. 49, No. 4, 1968, pp. 67-69.
[11] S. F. Cheng, “Bilateral Coccidioidal Epididymitis,” Urology, Vol. 3, No. 3, 1974, pp. 362-363. doi:10.1016/S0090-4295(74)80124-X
[12] J. E. Gottesman, “Coccidioidomycosis of Prostate and Epididymis with Urethrocutaneous Fistula,” Journal of Urology, Vol. 4, No. 3, 1974, pp. 311-314. doi:10.1016/0090-4295(74)90384-7
[13] W. T. Conner, G. W. Drach and W. C. Bucher, “Genitourinary Aspects of Disseminated Coccidioidomycosis,” Journal of Urology, Vol. 113, No. 1, 1975, pp. 82-88.
[14] E. A. Petersen, B. A. Friedman, E. D. Crowder and D. Rifkind, “Coccidoidouria: Clinical Significance,” Ann Internal Medicine, Vol. 85, No. 1, 1976, pp. 34-38. doi:10.7326/0003-4819-85-1-34
[15] K. T. Chen, “Coccidioidomycosis of the Epididymis” Journal of Urology, Vol. 130, No. 5, 1983, pp. 978-979.
[16] J. C. Liao and R. E. Reiter, “Coccidioidomycosis Presenting as Testicular Mass,” Journal of Urology, Vol. 166, No. 4, 2001, p. 1396. doi:10.1016/S0022-5347(05)65785-0
[17] A. Singer, “Coccidioidomycosis of the Epididymis and Testicle,” Infectious Urology, Vol. 15, No. 2, 2002, pp. 21-25.
[18] E. S. Halsey, M. S. Rasnake and D. R. Hospenthal, “Coccidioidomycosis of the Male Reproductive Tract,” Mycopathologia, Vol. 159, No. 2, 2005, pp. 199-204. doi:10.1007/s11046-004-6260-0
[19] M. R. Sohail, P. E. Andrews and J. E. Blair, “Coccidioidomycosis of the Male Genital Tract,” Journal of Urology, Vol. 173, No. 6, 2005, pp. 1978-1982. doi:10.1097/01.ju.0000158455.24193.12
[20] T. M. Dykes, A. B. Stone and E. D. Canby-Hagino, “Coccidioidomycosis of the Epididymis and Testis,” American Journal of Roentgenology, Vol. 184, No. 2, 2005, pp. 552-553. doi:10.2214/ajr. 184.2.01840552
[21] D. Ruggles, “Testicular Coccidioidomycosis,” Urologic Nursing, Vol. 28, No. 2, 2008, pp. 113-114.
[22] T. M. Chiller, J. N. Galgiani and D. A. Stevens, “Coccidioidomycosis,” Infectious Disease Clinics of North America, Vol. 17, No. 1, 2003, pp. 41-57. doi:10.1016/S0891-5520(02)00040-5

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